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General NPI Number Information
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NPI Number | 1922551563
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Entity Type | Organization
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Legal Business Name | NATURAL STATE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 1803 SW REGIONAL AIRPORT BLVD STE. 9
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City | BENTONVILLE
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State | AR
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Zip | 72712-7755
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Country | US
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Telephone | 479-319-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 1803 SW REGIONAL AIRPORT BLVD STE 9
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City | BENTONVILLE
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State | AR
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Zip | 72712-8792
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Country | US
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Telephone | 479-319-6211
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DILLON QUAYED CRAWFORD
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Credential | D.C
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Telephone | 479-319-6211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16143
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License Number State | AR
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